Background: Ambulance nurses (ANs) perform their work in situations which have not been planned. In such settings, the care of children can be extra challenging. Challenges might be pharmaceutical dosage, vital parameters that differ from adults, and the child's verbal development. Despite such challenges, the ANs must make the child participatory and listen to the child's voice. Such measures are described in child-centred care (CCC), which highlights the importance of care from the child's perspective.
Aim: To describe ambulance nurses' experiences of facilitating child-friendly care encounters.
Method: Seventeen individual semi-structured interviews were analysed with Reflexive Thematic Analysis.
Result: The overarching theme, Caring with the child in centre, consists of three themes that describe the ANs' efforts to keep the child in the centre of care. The three themes constitute Adapting to follow the child's lead, describing how the ANs adapted themselves and the child's care, and constantly being sensitive to the child's signals. Being reliable by balancing the trust highlighting the honest and direct communication with the child, and describing the role of proxy when the child's condition was acute. Last, Stepping back and supporting showing the AN's role as a guide in the care, letting the child and parent perform as much as possible, however always with the AN present in the background.
Discussion: The result indicates that the ANs work accordingly to CCC without it being expressed or aware. The importance of sensitivity to the child's perspective and autonomy is highlighted in CCC and is a typical work method for the ANs. Their communication with the child and the parents was direct and honest. That was considered imperative to safeguard the trust of the child. Earlier research describes the use of distractions to ease anxiety for the child. The present study suggests that the ANs instead use guided participation to make the child feel included and heard, thus reducing anxiety.
Conclusion: It can be beneficial to make the ANs close link to CCC made aware, to make it conscious and deliberate. By doing so, CCC and its closeness to the Child Act can be used in the training and development of pediatric care within the ambulance service. In addition, it can be important for the ANs to learn of the high care level they give the children.
2023.